Lactulose

You prescribe lactulose as you remember that this may effectively treat hepatic encephalopathy. You continue to monitor Andrew's mental status and neurological symptoms.  

You take this opportunity to revise the mechanism of action of lactulose in hepatic encephalopathy, in preparation for your final year exams. 

What is the mechanism of action of this drug in this setting? 

Alters ammonia metabolism by colonic bacteria
Activates somatostatin receptors
Activates vasopressin receptors
Antagonizes beta receptors
Sequesters bile acids

Map: Andrew Hall (1102)
Node: 20957
Score:

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OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • Furosemide and spironolactone
  • Request permission to record without explaining privacy
  • N acetyl cysteine
  • Allow the family member to stay on screen without clarifying their role
  • Start the consultation without verification
  • Activated charcoal
  • Ignore the wound complaint and focus solely on blood glucose
  • Give an immediate diagnosis without exploring the patient’s narrative
  • Propranolol
  • Aluminum hydroxide, magnesium carbonate, sodium alginate
  • Verify patient identity and obtain e-consent before starting.
  • Fluticasone (glucocorticoid)
  • Request permission to record without explaining privacy
  • Terbutaline (SABA)
  • Montelukast
  • Presentation
  • Insist on continuing with poor video quality
  • Switch to audio + chat mode and promise a PDF summary afterward
  • Tell the patient to change devices without giving proper guidance.
  • Reschedule without offering alternative solutions
  • Methionine
  • Salmeterol (LABA)
  • Ipratropium (SAMA, anticholinergic))
  • Reschedule with alternative (e.g., WhatsApp call) if needed
  • Ask rapid questions using medical jargon (ischemia, necrotic tissue, perfusion).
  • Ursodeoxycholic acid
  • Hyoscine
  • Sterculia
  • Lactulose

Reminder

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